Portable Patient Ventilator: Improving ICU Sedation

The ventilator duplicates at each ICU bedside the same method of anesthetizing patients that is used in the operating room.

Physicians working in the intensive care unit (ICU) frequently
face an unsettling dilemma: how to sedate patients deeply enough so
they're unaware of pain, but not so deeply that they experience
withdrawal symptoms once they’re no longer sedated.

UB researchers helped solve this quandary by designing a
portable patient ventilator that delivers small amounts of powerful
inhalation anesthetic agents as patients breathe or are
mechanically ventilated.

The aim is to duplicate at each ICU bedside the same powerful
and effective method of anesthetizing patients that works so well
in the operating room, but without the expensive equipment and
monitoring requirements.

The ventilator was invented by Bradley Fuhrman, MD, professor of
pediatrics and anesthesiology and chief of critical care at Women
and Children’s Hospital of Buffalo, and Mark Dowhy, director
of the Pediatric Critical Care laboratory in the Department of
Pediatrics.

A key advantage of inhaled anesthetics over intravenous
sedation—the current approach in the ICU—is that
inhaled anesthesia delivers and clears sedatives by way of the
metabolic and excretory systems. That’s a critical factor for
patients who have sustained damage to their kidneys or livers as a
result of their illness.

When anesthesia is delivered through the lung, there is a much
more rapid onset of effect and much quicker reversal once
it’s removed. This is an especially important consideration
in patients who need to be frequently or abruptly awakened, such as
children who have suffered trauma to the skull.

“With our ventilator, the patient is continually
rebreathing the same anesthetic and oxygen mixture, so the amount
of anesthetic that is used can be reduced by about 80
percent,” Fuhrman explains.

The device also has promising applications in treating large
numbers of patients during pandemics or other events with mass
casualties because it can safely enable multiple patients to share
a single ventilator.

Rajendram
Rajnarayanan, PhD, studies interactomes of the human estrogen
receptor, which is expressed in 70 percent of breast cancers. His
lab seeks to design molecules to improve the effects of
tamoxifen, a drug commonly prescribed to treat breast cancer.

Mulchand
Patel, PhD, is a specialist in nutritional biochemistry. He
found that fetuses of obese mother rats were programmed in utero to
develop obesity in adulthood, and was the first to show that this
metabolic programming occurs in the fetal hypothalamus.

Thomas
Russo, MD, is internationally known for his work with strains
of E. coli that cause infections outside the intestine and result
in morbidity worldwide due to pneumonia, urinary tract infections
and meningitis.

Suzanne
Laychock, PhD, is investigating the cellular mechanisms
regulating insulin secretion in pancreatic cells. Her group has
used pancreatic cells in primary culture to develop in vitro
systems that mimic aspects of Type 1 and Type 2 diabetes.

Te-Chung
Lee, PhD, demonstrated for the first time, in an animal model,
that injecting adult bone marrow stem cells into skeletal muscle
can repair cardiac tissue, reversing heart failure. He and his team
showed that this non-invasive procedure increased heart cells
two-fold.

Gabriela
Popescu, PhD, is studying NMDA receptors in the brain, which
are involved in synaptic development, plasticity, memory and
learning, as well as in pathologies such as stroke,
neurodegeneration, chronic pain, addiction, schizophrenia and
epilepsy.

James
R. Olson, PhD, has traveled to Egypt to work with cotton
laborers exposed to pesticides. His research links genetics, an
individual’s degree of exposure to pesticides and effects on
health, seeking to improve workplace and environmental health
worldwide.

Michael
Garrick, PhD, identified the first protein essential for normal
intestinal iron absorption and the first mammalian iron transporter
to be characterized at the molecular level. His work provides a
major step forward in the understanding of iron metabolism.

Daniel
Kosman, PhD, studies how organisms acquire and metabolize iron
and copper, intrinsically toxic metals essential to cellular
respiration and oxygen transport. One of his goals is to develop
antifungal drugs to treat infections in humans.